Running Clinic

Core Body Clinic has a specialist service for those who are running, thinking of running, suffering from a running injury, recurrent injury or has a running injury.

The service is designed to look at your running style, footwear, training pattern, biomechnaics, assess your injury, take a full and detailed history of your problem an then design a plan of action to get you back running.

All physios and Sports Therapist are trained in gait analysis and have experience in advising on footwear and the managament of injuries with insoles.

In an ideal world runners would run pain free 100% of the time. No aches, no niggles, no after exercise soreness, no rainy days and there would be no such thing as ‘over pronation’.

Unfortunately, this is more than often not the case. Training begins, we feel more heroic and indestructible as time goes on, niggles appear, pain persists, we feel stiffer and then our training becomes limited and painful. We logically take a rest in the hope that this sudden onset of symptoms will clear in time for Reading Half marathon in 4 weeks time.

The old saying of “use it or lose it” has a lot of relevance for running, training and general movement. So total rest is not always the answer.

Assessment:

Assessment is very important when looking into the problems that have developed bacause of running. There is so much we can learn from just talking to you, understanding your training habits, training goals, training needs and from here we can work out what is going wrong. The signs and symptoms, frequency and nature of pain will often give us an indication of the most likely structure causing you pain. From here we are already thinking about the best way to manage your problem to get you back to running and training.

We will assess you and take a holistic view at the body taking into consideration your foot posture, overall back position, range of movement in the spine and general muscular length. Function is key and we will want to look at activities like lunges, squats, and how you move with common movement patterns.

Lastly we will look at your running style with your preferred running shoes on. If we are able we will asses you running freely and where this is not possible we will place you on a treadmill and observe your running. It is important to have an understanding of your style but this should not bias our assessment. So much can be gained from what you tell us and then whhat your general movement and posture looks like

Running shoe assessment is key as we want to see how they have worn. If we suspect a problem with foot posture then this will help us to confirm or refute whether foot control is a factor if there is excessive wearing on a particular side of the shoe.

“Listen to the Body”

Listen a little and apply logic. Your brain cant diagnose all that well. If something seems wrong then see a sports physio. A little reassurance can prevent an unnecessary 4 weeks out of training only to find that you should have been modifying your training while the niggle resolves.

When we over train our body’s go through a process of adaptation. We need some time to recover for our tissues to develop to the new level of activity and then we able to continue. The post exercise soreness in the initial phases of training or increased training intensity is a common finding. It is quite normal and shouldn’t be seen as something that is damaging to the body. Pain and soreness usually lasts a day or two and should be a mild discomfort but shouldn’t interfere with function. The first day down the stairs may be a little sore but should be gone by day 2 and as training develops this will lesson. If you are sore still on day three and stairs are still painful then it would be futile to run again that day. Essentially, the pain is fibre ‘damage’. We call this delayed onset muscle soreness. While it is soreness we should consider it a minor injury. Again, we are not irreparably damaging the muscles. They are going through a process of adaptation and in order for the tissues to develop they need stress. The stress of exercise will disrupt muscle fibres and cause micro haemorrhaging inside the muscles. In response to this the body essentially (and simply) develops a stronger muscle capable of greater stress and demand during exercise. Basically, you get fitter.

Light exercise on a bike with light resistance and 70-80 rpm the day after a heavy session is sometimes quite therapeutic and provided the soreness reduces after 5 minutes then we have often found this to be beneficial.

Pain that is absent while engaging in normal function but returns when running commences is something that should be looked at by a professional. It maybe as simple as modifying your regime but nonetheless getting some sound advice can help you manage the condition while you recover.

Pronation

Pronation is a dirty word. A horrible affliction that causes all sort of problems and plagues the runner. Well, kind of………………………….

Pronation is an entirely normal motion in the foot and occurs when the foot hits the floor. The arch drops slightly, tightens the planter ligament and enables energy storage to provide propulsion for the foot allowing the to lift heel off leading onto the next step. The problem with pronation is how well we control it.

Excessive and poorly controlled pronation causes rotation of the tibia, hyper extension of the spine, and eversion of the ankle. Again, these are a problem if the muscles controlling them fail to control the motion.

Shin plints, achilles tendon pain, planterfasciitis, bursitis and lower back pain are all associated with poorly balanced foot mechanics. If you have older trainers then think about some new ones! As a general rule, if you run x 4 a week with 2 x 10k, average build, race 1 every 2 weeks in the season then a good shoe will last 6- 8 months. 12 at a push.

Shoes and orthotics can play a vital role in providing support when the muscles fail to do their job. Now, we have long believed that this was an entirely biomechanical process where the supporting footwear provides a pillar of support to the navicular bone. However, even the most subtle of arch supports from the shoe or orthotic can be very therapeutic by providing a proprioceptive (Sensory) cue to the brain. It can be so powerful and suggestive that the whole arch lifts, activated by the intrinsic foot muscles. The brain kicks a familiar movement process into place causing the gluteal muscles to contract and the entire leg to re-align. This then helps support the foot and maintain a more neutral foot positon. It prevents the foot from dropping out of control.

A good pair of shoes can work wonders here so choosing the right fit is essential. At Core Body Clinic we can advise on the type of shoe best suited and we can also assess and fit you for an appropriate foot bed or insole. This can help control the amount of foot rotation and therefore prevent lower limb injuries. We prefer the solution made by Formthitics systems who have built and refined an orthotics for nearly 20 years. Company Director Adrian Wagstaff has used them for the last 12 years, both personally and for his patients. At Core Body Clinic we can help you choose the correct system for your foot and body type.

Tendon Pain

Runners are often familiar with an Achilles Tendonitis

Pain that has developed over the tendons (Achilles, Patella Tendon) can also occur with training and accounts for around 40% of all running injuries. They are the most frustrating of symptoms where there after appears to be no pattern. Running is variable, the pain sometimes improves with the run and then returns after. It can be impossible to run the next day and the first steps out of bed can be crippling.

Tendon pain needs structure to get it better. We have kept 1000’s of runners running for their goal while managing their tendon problem.

If you damage a muscle, or have a niggle, or pain that is not a tendon then more than often it goes away. However, Tendons are a little trickier.

With the current thinking (im sure it will be out of date next week!) it is felt that conditioning and de-conditioning are key to the development of tendon pain. Over training is often a cause of tendon pain………………yet loading (putting weight through the tendon) is felt to be one of the most effective ways of dealing with tendon pain.

When we assess tendons at Core Body Clinic we take a thorough history so that we know the when’s, the where’s and the how long does it take for pain to come on. These are key areas as we are gaining an understanding of irritability and therefore the time it takes for pain to come on. This is key to management, treatment and the single most important thing to keep you running. It also helps us to understand which exercises to give you and whether taping and possibly massage are going to be beneficial to you.

Unless you snap your tendon we will always aim to keep you running. We just need to diagnose the staging. If you have snapped it then we will get you running again!